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Number of N95 masks required for a pandemic

Of the approximate 7.3 Billion N95 masks that are needed for U.S. healthcare workers to deal with a pandemic of global proportions, the United States of America national stockpile is at 0.1% of that capacity. This article from the Atlantic’s Olga Khazan (April 10, 2020) examines some reasons why:

Of all the coronavirus-induced problems facing America, the mask shortage might be the most baffling. Masks are now so hard to find that health-care workers are reusing theirs multiple days in a row. Grocery-store workers, who are at high risk of contracting the virus, have been denied masks for months. Everyday people are making their own out of fabric scraps.
One reason the U.S. ran short of masks is that many of them are manufactured in China; the country slowed mask manufacturing and stopped shipping them to the U.S. during its own coronavirus outbreak. But America was supposed to have its own supply of masks in the Strategic National Stockpile, a secretive stash of emergency supplies held in an undisclosed number of warehouses around the country. As of April 1, it was almost out.
The stockpile has been a consistent target of criticism throughout the COVID-19 pandemic, and there’s an obvious logic to that criticism: How did the richest country on Earth fail to hoard enough masks for a pandemic flu? One reason is that the Strategic National Stockpile distributed 85 million N95 respirators during the 2009 swine flu pandemic, along with millions of other protective masks. That distribution effort contributed to what is largely seen as a successful federal response to that outbreak. But those masks were never replenished.

At the beginning of the coronavirus outbreak, the stockpile contained only about 12 million of the 3.5 billion N95 masks that federal officials estimated the health-care system would need to fight this pandemic back in March. “I’m not aware of a major effort to restock the stockpile with N95 respirators after the 2009 drawdown,” Charles Johnson, the president of the International Safety Equipment Association, told me.
But the stockpile was never intended to be the nation’s great savior. It wasn’t supposed to provide all of the nation’s medical-supply needs for a multi-month pandemic. Congress never doled out enough money for it to do so. Instead, the officials who monitored the national stockpile were hopeful that hospitals were making their own stockpiles. But to save money, they largely weren’t. In that context, the skimpy mask supply in the Strategic National Stockpile is not the thing that derailed the American response to COVID-19. Rather, it’s one of a series of planning failures that created the crisis we’re in today.
Just like everything else in the government, the Strategic National Stockpile is funded through congressional appropriations. That means there’s a limited amount of money to be spent, and the people in charge of the stockpile have to decide how to spend it. Officials bought millions of N95 masks and other flu-type preparations with supplemental congressional funding that trickled in from 2005 to 2007, says Greg Burel, who was the director of the stockpile from 2007 until January 2020. But then that supplemental money dried up.
With the remaining money, the officials in charge of the stockpile had to decide whether they wanted to plan for a hurricane, flood, tornado, pandemic, or terrorist threat. All of those disasters require the stockpile to be stocked with different stuff. “It isn’t like comparing apples and oranges,” says Tara O’Toole, a former homeland-security official who chaired an advisory committee on the stockpile and who is now executive vice president at In-Q-Tel. “It’s like comparing apples and Volkswagens and bird food.”

After 9/11, the people in charge of the stockpile were concerned about bioterrorism—threats like anthrax—and sudden, mass-casualty events like, say, a bombing at the Super Bowl. This made some sense, but in the process officials took their foot off the pandemic-preparedness gas pedal. The response to the 2009 swine-flu pandemic was seen as a success, and the stockpile-minders moved on to the next item on their disaster checklist. “I think as human beings, we sometimes, not that we get complacent, but it’s like, Oh, we’ve got this. And we did. We had it,” says Deborah Levy, who oversaw the stockpile as acting division director for the Centers for Disease Control and Prevention in 2013 and 2014, while Burel was in another role.
Because officials weren’t as worried about pandemic flu, they stocked fewer basic medical supplies, like masks, that would come in handy during an infectious-disease outbreak. Officials thought the stockpile should have bioweapon antidotes and other drugs that aren’t easily available on store shelves, rather than common items you can buy at CVS. “The Strategic National Stockpile was built to respond primarily to chemical, biological, radiological, and nuclear events, whether by a terrorist, or a state actor, or something that might happen along those same lines that was accidental,” Burel told me.

Remainder of the article can be found here.